Medicare and Mental Health Coverage: A Guide for Seniors with Depression

Medicare and Mental Health Coverage: A Guide for Seniors with Depression

By Cynthia Thaik, M.D.

Photo by Abhilash Mishra from Pexels

Though depression is a common mental health problem among seniors, it is not a normal part of aging. The majority of older adults enjoy happiness and a high degree of life satisfaction in their golden years. If you are suffering from depression, it’s important to get help. Depression can worsen the outcome of many ailment, particularly heart disease. Fortunately, Medicare can help you cover some of the costs of your mental health treatments. Here’s how to get started with Medicare and the steps you can take to find treatment providers.

Learning About Medicare Plans

There are plenty of great online resources where you can learn everything you need to know about Medicare, from signing up to choosing supplementary plans. Once you’re enrolled, it’s important to stay up to date on changes to your plan since it’s common for Medicare to increase premiums and deductibles or introduce new programs and extended coverage each year.

Which Mental Health Services Are Covered by Medicare?

Original Medicare, also called Medicare parts A and B, covers a range of mental health services. Medicare Part A covers mental health care in a psychiatric facility or general hospital while Medicare Part B can help you pay for outpatient mental health care. For example, Part B covers things like depression screenings, psychotherapy, family counseling, diagnostic testing, and some prescription drugs. Medicare even includes an introductory risk assessment visit so that doctors can help you make a plan to manage existing factors that may contribute to depression, such as your family history and current health.

Choosing Supplemental Plans

Supplemental Medicare plans, also called Medicare Advantage plans, can fill in many of the gaps in coverage where Medicare requires you to pay out of pocket. The plans vary in terms of coverage since they’re offered by private insurance companies. Make sure you do your research on insurance companies and their plan coverage before signing up. Though you can add prescription drug coverage to your Original Medicare plan, most Medicare Advantage plans include this—which could be useful for people requiring pharmaceutical mental health treatments. Medicare Advantage plans are also a good option if you want more flexibility to choose special mental health services and more options for mental health providers.

Finding Mental Health Professionals That Accept Medicare

Many doctors accept Medicare, but it can be difficult to find a therapist or mental health care specialist who does. According to Quartz, only 54.8 percent of psychiatrists accept Medicare. You can use online resources, like this one from Psychology Today, to find therapists in your state who take patients with Medicare coverage. If you’ve already been going to a mental health professional who does not accept Medicare, you may be able to convince them to give you a discount or set up an extended payment plan. Alternatively, you can ask them to refer you to a new therapist that accepts Medicare.

Ensuring Your Mental Health Care Provider is Recognized

Even if your mental health care professional accepts Medicare or private insurance, their services may not be covered by your plan. Ensure that your therapist, doctor, or psychiatrist is recognized by the Centers for Medicare and Medicaid Services (CMS). To be recognized, your mental health supplier must be a psychiatrist, clinical social worker, clinical nurse, clinical psychologist, or a general doctor. On top of this, providers must meet certain credential requirements and legal qualifications. A mental health counselor is one example of a service provider that is not recognized by the CMS, so make sure to check with your specific Medicare plan before committing to treatment with a professional.

Getting help for depression can be intimidating. Remember, treatment is a readily-available and effective way to feel better. Take advantage of Medicare to cover your mental health treatment without breaking the bank so you can enjoy higher quality of life in your senior years.

About the author

Dr. Cynthia Thaik, M.D. is a Harvard-trained cardiologist serving the greater Los Angeles community at her holistic health center in Burbank and Valencia, CA. Dr. Thaik is the author of Your Vibrant Heart: Restoring Health, Strength, and Spirit from the Body’s Core. To learn more about Dr. Thaik or the Holistic Healing Heart Center, or to schedule an appointment, please contact staff@drcynthia.com or call (818) 842-1410.